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- Koch, Christian, 1958, et al.
(författare)
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Information standards - A hinder or an enabler for innovation?
- 2018
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Ingår i: Proceeding of the 34th Annual ARCOM Conference, ARCOM 2018. - 9780995546325 ; , s. 27-36
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Konferensbidrag (refereegranskat)abstract
- © Proceeding of the 34th Annual ARCOM Conference, ARCOM 2018. The potential of cost reduction by efficient digital communication in building processes in Sweden has been investigated to be 15-25% of the building sum. An important part of this potential is by using building information standards, such as Omniclass and IFC. This research has aimed at evaluating the use of building information standards and its impact on innovation. Standards are understood as classification of information and rules for building processes. Selected literature help reveal the multiple character of relevant standardization in building and the effects on innovation. Ten types of effect are identified. Three national longitudinal case studies of hospital projects in Scandinavia were carried out. Many barriers for innovation when using standards were found. The regional public authorities can decide to adopt standards locally and in two out of three cases they did not. For the companies this is a business consideration: In the Norwegian case, the proactive adoption of the architect, meant benefits for the client and contractor. However, other actors did not follow. In the Swedish case, BIM coordination was hampered by incompatible design systems. In the Danish case, the client demanded use of Cuneco Classification System, a Danish information standard, but the classification was done in a reactive manner at a late stage. The Danish and the Norwegian case were innovative, but the Swedish less so. Nine out of ten types of effects were found in the cases. Standard-enabled innovations were mixed with other innovations. The two most remarkable were the Danish reverse innovation, and the Norwegian shift of structural concept. The information standards and BIM are closely intertwined in practice. A common database of coded objects in the Danish case is a strong innovation enabled by standards. The use of TFM, in the Norwegian architect project and its subsequent use in site BIM is remarkable.
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| 2. |
- Koch, Christian, 1958, et al.
(författare)
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Yet another Trojan horse? Is Facility Management Ready for Digitalisation?
- 2017
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Ingår i: Ruddock, L, Van-Dijk, H and Houghton, CAM, (eds.) 2017, International Research Conference 2017: Shaping Tomorrow's Built Environment - conference proceedings, University of Salford, Salford, UK. - 9781912337040
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Konferensbidrag (refereegranskat)abstract
- Digital practices of facility management (FM) are still rare. Several Nordic countries have ambitious hospital building projects, driven by large public clients with long term experience of operating complex building campuses. There is thus an opportunity of creating state of art regarding digital FM. However, a recurrent problem is that a technically focused implementation leads to prolonged learning and practice development in the involved organization and never get operational. Hence members of organisations successfully resist the perceived Trojan horse entering. This paper aims at investigating the role of digital FM in new hospital projects in Scandinavia. Based on a literature review, a framework of understanding of digital FM in hospital operation is established. This highlight the importance of integration between technical digitalization, competences, organization and management of digital FM. Two longitudinal cases are presented and analysed. A greenfield hospital and an extension of an existing hospital. The projects are in different phases and represent quite advanced preparations for digital FM. State of the art software FM system are prepared before operation. External consultants are involved, posing a dilemma of inhouse/outsource human resources in the future digital FM operation. The importance of managerial, organizational and competence preparation is highlighted as implication.
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| 3. |
- Odland, Maria Lisa, et al.
(författare)
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Effects of refresher training on the use of manual vacuum aspiration in the treatment of incomplete abortions : a quasi-experimental study in Malawi.
- 2018
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Ingår i: BMJ Global Health. - : BMJ. - 2059-7908. ; 3:5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The maternal mortality ratio is decreasing globally, although it remains high in Malawi. Unsafe abortion is a major cause and treatment of complications after abortion is a big burden on the health system. Even though manual vacuum aspiration (MVA) is the recommended surgical treatment of incomplete abortions in the first trimester, many hospitals in Malawi continue to use sharp curettage. It is known to have more complications and is more expensive in the long run. The purpose of this study was to determine the effectiveness of a structured MVA training programme in the treatment of incomplete abortions in Malawi.Methods: A quasi-experimental before-and-after study design was employed in an MVA training programme for health personnel at three hospitals in Southern Malawi. A total of 53 health personnel at the Queen Elizabeth Central Hospital and the district hospitals of Chikwawa and Chiradzulu (intervention hospitals) were trained in the use of MVA. Kamuzu Central Hospital in Lilongwe and the Thyolo District Hospital served as control institutions. Medical files for all women treated for an incomplete abortion at the study hospitals were reviewed before and after the intervention. Information on demographic and obstetric data and the type of treatment was collected.Results: There was a significant increase in the use of MVA from 7.8% (95% CI 5.8 to 10.3) to 29.1% (95% CI 25.9 to 32.5) 1 year after the intervention. In comparison, we found a mere 3% increase in the control hospitals.Conclusions: By providing a refresher training programme to health personnel who treat women with incomplete abortions, it was possible to increase the use of MVA as recommended in the Malawi national guidelines.
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| 4. |
- Odland, Maria Lisa, et al.
(författare)
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The Use of Manual Vacuum Aspiration in the Treatment of Incomplete Abortions : A Descriptive Study from Three Public Hospitals in Malawi
- 2018
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 15:2
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Tidskriftsartikel (refereegranskat)abstract
- Malawi has a high maternal mortality rate, of which unsafe abortion is a major cause. About 140,000 induced abortions are estimated every year, despite there being a restrictive abortion law in place. This leads to complications, such as incomplete abortions, which need to be treated to avoid further harm. Although manual vacuum aspiration (MVA) is a safe and cheap method of evacuating the uterus, the most commonly used method in Malawi is curettage. Medical treatment is used sparingly in the country, and the Ministry of Health has been trying to increase the use of MVA. The aim of this study was to investigate the treatment of incomplete abortions in three public hospitals in Southern Malawi during a three-year period. All medical files from the female/gynecological wards from 2013 to 2015 were reviewed. In total, information on obstetric history, demographics, and treatment were collected from 7270 women who had been treated for incomplete abortions. The overall use of MVA at the three hospitals during the study period was 11.4% (95% CI, 10.7–12.1). However, there was a major increase in MVA application at one District Hospital. Why there was only one successful hospital in this study is unclear, but may be due to more training and dedicated leadership at this particular hospital. Either way, the use of MVA in the treatment of incomplete abortions continues to be low in Malawi, despite recommendations from the World Health Organization (WHO) and the Malawi Ministry of Health.
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